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Carer harm: a challenge for practitioners, services and research
Get PDFPurpose The purpose of this study is to consider how carer harm is understood, surfaced and responded to in contemporary policy, practice and research. Design/methodology/approach This paper offers a reflective commentary on the current “state of play” relating to carer harm drawing on existing research and related literature. This study focuses on how we define carer harm and what we know about its impact; lessons from, and for, practice and service provision; and (some) considerations for policy development and future research. Findings The authors highlight the importance of engaging with the gendered dimensions (and inequalities) that lie at the intersection of experience of care and violence and the need to move beyond binary conceptions of power (lessness) in family and intimate relationships over the life course. They suggest that changing how we think and talk about carer harm may support practitioners to better recognise the impact of direct and indirect forms of carer harm on carers without stigmatising or blaming people with care needs. The findings of this study also consider how carer harm is “hidden in plain sight” on two accounts. The issue falls through the gaps between, broadly, domestic abuse and adult and child safeguarding services; similarly, the nature and impact of harm is often kept private by carers who are fearful of the moral and practical consequences of sharing their experiences. Originality/value This study sets out recommendations to this effect and invites an ongoing conversation about how change for carers and families can be realised
Innovation and diversity in public health team engagement in local alcohol premises licensing: qualitative interview findings from the ExILEnS study
Get PDFBackground: Evidence suggests that controls on the physical and temporal availability of alcohol can reduce alcohol-related harms. Public health teams (PHTs) in England and Scotland have in recent years been given a statutory role in licensing systems through which premises are granted permits to sell alcohol. The ExILEnS (Exploring the Impact of alcohol Licensing in England and Scotland) study examined PHT efforts to engage in alcohol licensing from 2012-2019. Objective: We aimed to describe the range of PHT practice in engaging with alcohol licensing across England and Scotland, with a particular focus on unusual or innovative practices. Methods: Two sets of interviews were conducted with 20 PHTs in England and Scotland who were actively engaged in alcohol premises licensing. Firstly, representatives of each PHT with experience of licensing activity took part in structured face-to-face or telephone interviews (n=41) and provided documentation to identify how and when their team engaged with alcohol premises licensing. Secondly, members of PHTs, took part in in-depth one-to-one interviews (n=28) focused on individual roles and responsibilities. Relevant PHT activity was analysed quantitatively within nineteen activities in six categories using the ‘Public Health engagement in Alcohol Licensing’ (PHIAL) Measure, as well as qualitatively using NVivo. Innovative practices were identified using the highest PHIAL scores for specific activity types across single or multiple six-month periods. Findings: Within each of the six activity categories, a range of practices were observed. More unusual practices included: having a dedicated post to work full-time on alcohol licensing; developing a standardised reviewer tool allowing the team to respond to applications and provide the most relevant evidence in a consistent and systematic way; committing to additional scrutiny of occasional licenses or temporary event notices; maintaining a detailed database recording applications made, whether the PHT decided to object and the outcome of the licensing board’s decision; engaging with applicants prior to them submitting an application; visiting proposed/current licensed premises to gather bespoke data; leading the writing of local licensing policy; and working closely with licensing standards officers. Conclusions: Across six categories of PHT activity relating to the local alcohol premises licensing system, PHT practices varied and some PHTs stood out as engaging in more innovative or intensive activities. The identified examples will be of value in informing PHT practice in what remains a relatively new area of work for many, despite limitations in the system. The inclusion of examples from both England and Scotland and from many PHTs will facilitate cross-fertilisation of ideas and practice across PHTs
Fluvial flooding and plastic pollution – The delivery of potential human pathogenic bacteria into agricultural fields
Get PDFThe frequency of plastic debris entering agricultural land is likely going to increase due to increased discharge into surface waters and more frequent flood events. Microbial biofilm on the surfaces of plastic pollution (known as the ‘plastisphere’) in freshwater environments often includes human pathogenic bacteria capable of causing disease. Pathogens have been detected on the surface of plastics in freshwater environments, but it is yet to be determined whether plastic debris can also transport pathogens into agricultural fields during flooding. Therefore, this study quantified the presence of viable pathogenic bacteria on the surface of plastic pollution at five agricultural fields along two rivers. All visible plastic debris, including sewage-associated plastic waste, were collected along a perpendicular 100 m transect from the riparian zone into each field. All plastic pieces were screened for five target bacteria (Escherichia coli, intestinal enterococci, Salmonella spp., Campylobacter spp., and Klebsiella spp.) using selective media, and positively identified colonies subsequently tested for antimicrobial resistance. In all five fields, there were higher volumes of plastic in the areas closer to the river, with 75% ± 24% of plastic collected within 30 m from the riverbank. Overall, 49% of all plastic collected in agricultural fields was colonised by phenotypically positive colonies for at least one or more target bacteria, with resistance to commonly prescribed antibiotics detected among several of these target bacteria. Therefore, the transport of contaminated plastic debris from fluvial floodwater into agricultural fields could pose an as yet unquantified risk of introducing potentially harmful bacteria into agricultural systems and the ultimately into the food chain
Towards a global understanding of tree mortality
Get PDFRates of tree mortality are increasing globally, with implications for forests and climate. Yet how and why these trends vary globally remains unknown. Developing a comprehensive assessment of global tree mortality will require systematically integrating data from ground-based long-term forest monitoring with large-scale remote sensing. We survey the metadata from 466,865 forest monitoring plots across 89 countries and five continents using questionnaires and discuss the potential to use these to estimate tree mortality trends globally. Our survey shows that the area monitored has increased steadily since 1960, but we also identify many regions with limited ground-based information on tree mortality. The integration of existing ground-based forest inventories with remote sensing and modelling can potentially fill those gaps, but this requires development of technical solutions and agreements that enable seamless flows of information from the field to global assessments of tree mortality. A truly global monitoring effort should promote fair and equitable collaborations, transferring funding to and empowering scientists from less wealthy regions. Increasing interest in forests as a natural climate solution, the advancement of new technologies, and world-wide connectivity means that now a global monitoring system of tree mortality is not just urgently needed, but also possible.International Tree Mortality Network members: Cornelius Senf, Adriane Esquivel-Muelbert, Thomas A. M. Pugh, William R. L. Anderegg, Kristina J. Anderson-Teixeira, Gabriel Arellano, Mirela Beloiu Schwenke, Barbara J. Bentz, Hans Juergen Boehmer, Ben Bond-Lamberty, Kauane Maiara Bordin, Francis Q. Brearley, Filippo Bussotti, Maxime Cailleret, J. Julio Camarero, Gherardo Chirici, Flavia R. C. Costa, Ricardo Dalagnol, Hendrik Davi, Stuart J. Davies, Sylvain Delzon, Bishnu Prasad Dhakal, Renato A. Ferreira de Lima, Marco Ferretti, Joseph B. Fontaine, Matteo Garbarino, André Luís de Gasper, Arthur Gessler, Gregory S. Gilbert, John L. Godlee, Francisco Maiato Pedro Gonçalves, Leen Govaere, Alvaro G. Gutiérrez, Ernesto Gómez Cardozo, William M. Hammond, Henrik Hartmann, Martina L. Hobi, Andrés Holz, Jürgen Homeier, Mark Joseph Hovenden, Cho-ying Huang, Bruno Hérault, Toby Jackson, Tommaso Jucker, Alistair S. Jump, Samuli Junttila, Teja Kattenborn, Joice Klipel, Martyna M. Kotowska, Kamil Král, Nicola La Porta, Leonel Lopez-Toledo, René López-Camacho, Eduardo Eiji Maeda, Jesús Mallol Díaz, Emanuel H. Martin, Jordi Martínez-Vilalta, Nate McDowell, Peter W. Moonlight, Akira S. Mori, Mohd Afzanizam Muda, Jan-Peter Mund, Robert Muscarella, Moisés Méndez-Toribio, Sandra C. Müller, Thomas A. Nagel, Stefan Neagu, Charles Andrew Nock, Moses Nsanyi Sainge, Michael J. O'Brien, Josep Peñuelas, George L. W. Perry, Oliver L. Phillips, Juan Manuel Posada, Ricardo Ribeiro Rodrigues, Anamaria Roman, Guillaume Xavier Rousseau, Nadine Katrin Ruehr, Paloma Ruiz-Benito, Katinka X. Ruthrof, Christian Salas-Eljatib, Tanja G. M. Sanders, Rodrigo Scarton Bergamin, Tobias Scharnweber, Mart-Jan Schelhaas, Bernhard Schuldt, Selina Schwarz , Rupert Seidl, Ekaterina Shorohova, Ana Carolina Silva, Geert Sioen, Jarosław Socha, Krzysztof Stereńczak, Jonas Stillhard, Dejan B. Stojanović, Susanne Suvanto, Miroslav Svoboda, Martina Sánchez-Pinillos, Andrew J. Tanentzap, Anthony R. Taylor, Fabiano Turini Farah, Giorgio Vacchiano, Alexander C. Vibrans, Alberto Vilagrosa, Emilio Vilanova, Lars T. Waser, Susan K. Wiser, Kailiang Yu, Miguel A. Zavala, Laio Zimermann Oliveira, Daniel Zuleta, Alvaro Boson de Castro-Faria, Ernst van der Maaten, Marieke van der Maaten-Theunisse
Impact of price shocks and payments on crop diversification and forest use among Malagasy vanilla farmers
Get PDFCrop diversification can help buffer farmers from market volatility and provide alternatives to unsustainable export-driven cash crop monocultures that are also driving forest clearing. We developed a discrete choice experiment (DCE) and an innovative tablet-based experimental game to predict the effects of price shocks and payment incentives on vanilla farmers' willingness to diversify their crops and support forest conservation in northeast Madagascar. The games incorporated spatial and ecological dynamics, and were conducted in groups of six participants using a within-subject design. The results of the DCE showed that farmers highly valued vanilla monocrops and were indifferent to diversified vanilla agroforestry. Women valued the relative earnings from diversified vanilla agroforestry more than men. In the games, the presence of shocks (a drop in vanilla price), led farmers to significantly diversify their crops. Shocks also incentivized more diversified land uses at the landscape level. Payments resulted in improved environmental outcomes through increased vegetation, but decreased crop diversity at the farm level. Payments also discouraged crop diversity among younger respondents. Focus groups followed the games and gave critical insights into game behavior. These findings shed light on the importance of market dynamics and payment schemes in encouraging pro-conservation behavior and crop diversification among farmers reliant on cash crops such as vanilla. We demonstrate how games can provide a low-risk, low-cost tool to predict the impacts of policy interventions
Epistemic Deprivation
Get PDFIt is often claimed that gender data gaps (GDGs) are unjust, but the nature of the injustice has not been interrogated. We argue that injustices arising from such data gaps are not merely socio-political but also epistemic: they arbitrarily skew the epistemic landscape in favour of one group over another. GDGs place a greater epistemic burden on women and gender minorities; they have to do more to avoid error and the pay-off is worse: they have a smaller pool of true beliefs on which to act. We suggest that there are both pragmatic and conceptual reasons to differentiate the injustice arising from GDGs from other more familiar varieties (such as testimonial and hermeneutical injustice), and so we introduce the new concept of epistemic deprivation to capture this injustice.Output Status: Forthcoming/Available Onlin
Exploring health literacy in developing economies: perspectives and practices of health communication professionals in rural Nigeria.
Get PDFBackground: Health literacy is widely recognised as a social determinant of health and key factor in health communication and education, with low health literacy correlated with poor health outcomes and socioeconomic inequalities. Health literacy is recognised as a core knowledge domain and competency required of health professionals, but there are limited empirical studies providing insights into professional understanding and practices, particularly in non-clinical public health communication and education roles. Whilst a global issue, health literacy is reported to be lower in developing economies and questions have been raised regarding professional health literacy perspectives and practices. Aims: This paper provides insights into the health literacy perspectives and practices of health communication professionals involved in public health communication and education in a rural region of Nigeria, providing new empirical insights into professional practices and challenges in a developing economy. Methods: Exploratory research design. Our data collection method was semi-structured interviews with 38 state and third sector professionals in public health communication management, dissemination, and education roles. Data analysis conducted via iterative cycles of pattern coding and thematic analysis. Results: Our professional participants all recognised health literacy as an important consideration in public health communication and demonstrated general awareness of key issues when communicating to rural populations in Nigeria. However, depth of perspectives and practices appear limited. All discussed health literacy in general layman’s terms with no referral to any health literacy policy, frameworks, models or specific competencies. Professional practices appear largely focused on issues of population illiteracy, linguistic diversity, and message complexity and reach, with no evidence of attention to acknowledged issues of mistrust and misinformation. Many participants also appeared to overestimate population health information seeking capabilities and none indicated any need for health literacy education for either themselves or their rural populations. Discussion: Findings suggest our professional participants’ understanding of health literacy and associated practices are focused on and/or limited to basic communicative and functional aspects. Recommendations are made for action-oriented research to review health literacy educational provision for practising professionals in the region, and to develop contextually appropriate and scalable methods of health literacy education for impoverished illiterate populations.Good Health and Well-BeingReduced Inequalitie
Resentful, Resigned and Respectful: Opioid Analgesics, Pain and Control, a Qualitative Study
Get PDFOpioid analgesic prescribing has increased significantly with associated concerns about dependence and overdose. This study aimed to explore non-cancer patients’ experiences and views of taking opioid analgesics to manage their pain. Twenty-two patients were purposively sampled from English GP practices and participated in semi-structured telephone interviews. Braun and Clarke’s thematic analysis was used to generate emerging latent and semantic themes. Patients resented taking opioid analgesics due to tolerance and addiction fears but were resigned to experiencing chronic pain. Control emerged in relation to patients’ acceptance of doctors’ control over treatment decisions but also patients’ attempted self-control over medicine adherence. This involved negatively perceived attempts to control pain but also prevent tolerance and addiction. Non-pharmacological treatments were viewed negatively by patients and addiction awareness arose from various sources. Patients were respectful of doctors but expressed negativity about the lack of addiction warnings, medication reviews and appointments. Family and friends were infrequently mentioned, as was reference to shared decision-making, suggesting patients navigate control over opioids and pain in relatively isolated ways. Patients reported generally negative experiences of opioid use for pain, which provides key insights for health professionals to enhance understanding and the management of such patients
The biogeochemical response of the north-western Black Sea to the Kakhovka Dam breach
Get PDFThe Kakhovka Dam explosion is an example of the far-reaching environmental consequences of warfare. The resulting dam collapse released some 14.4 billion cubic meters of water, flooding downstream environments and flushing unknown quantities of debris, pollutants and sediments into the north-western Black Sea. With a combined satellite and hydrological modelling approach, supported with in situ data, we assessed the short-term impact on the north-western Black Sea. The dam breach impacted more than 50% of the area of the north-western Black Sea, experiencing over 50 times the ambient Chlorophyll-a and suspended sediment concentrations. Significant increases of nitrate and phosphate were also observed in the Odesa coastal environment. This environmental shock triggered severe algal blooms within one week, that persisted for a further 20 days. This event may have impacted the biodiversity of the north-western Black Sea and its ecosystem response. Continued monitoring is required to assess the longer-term impacts
Novel model organisms and proteomics for a better biological understanding
Get PDFThe concept of « model organisms » is being revisited in the light of the latest advances in multi-omics technologies that can now capture the full range of molecular events that occur over time, regardless of the organism studied. Classic, well-studied models, such as Escherichia coli, Saccharomyces cerevisiae, to name a few, have long been valuable for hypothesis testing, reproducibility, and sharing common platforms among researchers. However, they are not suitable for all types of research. The complexity of unanswered questions in biology demands more elaborated systems, particularly to study plant and animal biodiversity, microbial ecosystems and their interactions with their hosts if any. More integrated systems, known as « holobionts », are emerging to describe and unify host organisms and associated microorganisms, providing an overview of all their possible interactions and trajectories. Comparative evolutionary proteomics offers interesting prospects for extrapolating knowledge from a few selected model organisms to others. This approach enables a deeper characterization of the diversity of proteins and proteoforms across the three branches of the tree of life, i.e. Bacteria, Archaea, and Eukarya. It also provides a powerful means to address remaining biological questions, such as identifying the key molecular players in organisms when they are confronted to environmental challenges, like anthropogenic toxicants, pathogens, dietary shifts or climate stressors, and proposing long-term sustainable solutions
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